Hello Dr. Bailey,
I have brown spots on my skin and I am wondering if there is a secret to ridding my skin of these?
The most common causes of flat brown spots on your skin are:
- Solar lentigos, also called freckles or liver spots, which are due to sun damage
- Melasma, also called “the mask of pregnancy,” although you don’t have to be pregnant to have melasma
- Post-inflammatory hyperpigmentation, which are brown marks that result from skin injuries such as bug bites, pimples, etc.
(Of course, moles can also be flat brown spots, but they are growths and are an entirely different subject.)
These types of acquired brown spots are tough to fix. This means that preventing them is best. Believe me; we will all get more brown spots as we age, unless we take steps to prevent them. Because prevention is such an important part of treating brown spots, I’m dividing this post into two sections:
- How to prevent brown spots on your skin
- How to lighten brown spots on your skin
How to Prevent Brown Spots on Your Skin
The extra pigment in brown spots is almost always fueled by sun exposure. This means that the most important step in preventing brown spots on your skin is using good sun protection every day, even for window sun. You need broad spectrum sunscreen that blocks both UVA and UVB rays since both of these rays will darken the brown spots, worsening the uneven skin pigmentation. I recommend wearing a really good mineral zinc sunscreen with 5% or more zinc oxide listed as an active ingredient. My favorite is Citrix Sunscreen for everyday use on the face, neck and chest. I’ve used it for years and trust my skin to it daily.
For parts of your skin that are constantly in water or rubbed by clothing all day, such as the back of your hands and outer surface of your arms, I recommend a water-resistant product, such as Solbar Zinc. Again, I’ve used this product for years and trust my skin to it!
Because I think these two sunscreens make up the perfect sun-protection combo, I’ve put them together in my SunSavvy Daily Wear Sun Protection Kit.
Don’t forget about wearing sun protective clothing, hats and sunglasses. Also, be sure to seek shade to keep the sun from darkening your brown spots. For my complete sun protection advice read my post 5 Steps for Smart Sun Protection.
How to Lighten Brown Spots on Your Skin
Once you are using good sun protection to prevent further darkening of your uneven skin hyperpigmentation problems, you now can get to work on lightening the unwanted color that’s already there. Lightening agents can be used to treat your brown skin spots. The simplest treatment is to use glycolic acid skin care products. This natural fruit acid works best in professional strength products with 10% or more free acid content of glycolic acid. When you use these products as a facial or body moisturizer after washing, they will slowly lighten uneven excessive skin pigment. I’ve used glycolic acid products for years in my dermatology practice and my patients love them.
Other lightening agents include hydroquinone bleaching products. In my experience, the 2% over-the-counter formulas have minimal success, but the prescription 4% products work better. I usually combine the bleaching products with either glycolic acid and/or the prescription retinoid tretinoin (Retin-A or Renova Creams). This combination helps the hydroquinone penetrate the skin better. Plus, the tretinoin and/or glycolic acid helps lighten uneven skin hyperpigmentation through their own unique mechanisms. Combined with sun protection, it’s the best skin care product combination for brown spots on the skin.
One of the most successful prescription skin care product kits with these ingredients is the Obagi Nu Derm System. The Obagi Skin Care Products work synergistically to really lighten your brown spots. The system includes 4% hydroquinoine, tretinoin and a glycolic acid “cousin.” To learn more about Obagi Nu Derm, read my post Obagi Skin Care Products.
Depending on the cause of your brown spots, you may also benefit from IPL/BBL treatments (these are laser/light treatments done in a doctor’s office). I administer these treatments in my office and have found them to be highly effective. To learn more about IPL/BBL treatments, click here.
Both the prescription and laser/light treatments for brown spots on your skin require a consultation with a dermatologist to determine if you are a good candidate for these treatments.
I hope this information helps you understand some of your options. Thanks for sending in a great question about a common problem that many people share.
Cynthia Bailey MD, Dermatologist
If you have questions about skin care or skin health, please send them to me using the Contact Dr. Bailey button at the top of the page.
Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only.